In which conditions is the surgery performed?
– Sweaty hands (palmar hyperhidrosis)
– Underarm sweating
– Facial sweating
– Facial blushing
– Sweaty feet
– Coldness and bluish discoloration of the fingertips (Raynaud's phenomenon)
When these conditions occur together, they can be corrected in the same operation. However, it is performed mainly for sweaty hands and underarm sweating.
It is not performed for sweaty feet; however, if sweaty feet accompany the sweating conditions above, the foot sweating resolves in 50 percent of patients.
What is ETS (Endoscopic Thoracic Sympathectomy)?
It is a procedure in which the chest cavity is entered with a video camera and a titanium clip is placed on the nerve that regulates sweating (the sympathetic ganglion), or the nerve is damaged (burned with electrocautery).
People who have previously had pleural inflammation or lung surgery are not suitable for ETS.
Advantages of ETS
– The procedure takes about 30 minutes on average.
– When the patient wakes up, the hands are dry and warm.
– It leaves very small scars.
– Less pain occurs.
Recovery is quick, and the effects of the surgery wear off in a short time. Patients are discharged on the 2nd day after surgery and can resume daily activities the same day.
Successful results are achieved in 98 percent of cases of hand sweating and over 80 percent of cases of underarm sweating; although it is not performed for foot sweating, about 50 percent success is seen in foot sweating as well.
Are there any complications of ETS?
Compensatory (reflex) sweating, meaning increased sweating in other parts of the body, is the most common side effect, occurring in 20–50% of patients. However, it is bothersome in only 2–3%. Another rare side effect is sweating while eating.
Allergic reactions to anesthetic agents and medications, bleeding, infection, and injury to adjacent organs, which can occur rarely or with any surgical procedure, may also develop.
Sometimes air may remain in the chest cavity (pneumothorax). In most cases, however, it resolves on its own and does not cause problems.
The complication known as Horner syndrome (drooping of the eyelid, constriction of the pupil, and reduced sweating of the face) may return to normal within a few months, although very rarely it can be permanent.
Waking up after surgery
After the operation, you will be transferred to your bed in the ward. The fluids and medications you need are given through the lines attached to your vein. Monitors record your heartbeat and the amount of oxygen in your blood.
Medications will be given to help you be more comfortable during your recovery. During this time you will also be given exercises that make it easier to breathe and move, and that improve these functions.